Provider Demographics
NPI:1487878302
Name:WIWART TRUSZKOWSKA, MARGARET (DDS)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:WIWART TRUSZKOWSKA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:WIWART
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1277 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07011-2240
Mailing Address - Country:US
Mailing Address - Phone:973-478-6123
Mailing Address - Fax:973-478-6131
Practice Address - Street 1:1277 MAIN AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07011-2240
Practice Address - Country:US
Practice Address - Phone:973-478-6123
Practice Address - Fax:973-478-6131
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0467101122300000X
NJ22DI01984600122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist